Patients with lower risk prostate cancer will be reassured that radiotherapy alone is effective following surgery, after findings from a 16-year long study have been released.
The results of the study, published in the Lancet yesterday (16 May), found there was “little benefit” to additional hormone therapy for low-risk prostate cancer patients, when compared with radiotherapy alone.
For patients with a higher risk of cancer returning, there was greater benefit to a two-year course of hormone therapy than a six-month course.
Radiotherapy for post-op prostate cancer
The phase III RADICALS-HD trial study, which began in 2008, divided 3,000 patients into three groups for randomised trials: radiotherapy alone, radiotherapy with six months of hormone therapy, and radiotherapy with two years of hormone therapy.
It was led by researchers from The Royal Marsden NHS Foundation Trust and the MRC Clinical Trials Unit at University College London, with funding from Cancer Research UK.
The study found 79 per cent of men, with lower risk prostate cancer, treated with radiotherapy alone survived without their cancer spreading and becoming incurable after 10 years. This is compared with 80 per cent of those treated with six months of hormone therapy and radiotherapy.
Researchers noted that this is a small difference and could be due to chance, showing no significant benefit of hormone therapy for lower risk patients.
For patients with a higher risk of their cancer returning, the benefits of six months versus two years of hormone treatment with radiotherapy were clearer.
Around seven in 10 (72 per cent) of those treated with the shorter course of hormone therapy survived without the initial cancer spreading after 10 years, compared with 78 per cent of those treated with the longer course. This showed that an extended course of hormone therapy could be more effective when treating advanced cancers.
'More effective treatment, no unnecessary intervention'
Chief investigator Professor Chris Parker, consultant clinical oncologist at the Royal Marsden and professor of prostate oncology at the Institute of Cancer Research said: “The new information from this practice-changing study will ensure clinicians can better tailor treatment for prostate cancer patients following surgery and help facilitate important discussions. This will mean some patients receive a more effective treatment while sparing others unnecessary intervention.
“The trial showed encouraging results for radiotherapy alone so some patients, concerned with upsetting side effects of hormone therapy, can be reassured this treatment is a good option. Other patients, at higher risk of their cancer returning, can have a better understanding of how effective hormone therapy might be for them and help them to decide the best possible path of treatment.”
Every year there are around 52,300 new prostate cancer cases in the UK, that's more than 140 every day.
Around 7,000 people with localised prostate cancer have surgery to remove their prostate each year. Around 2,000 of these go on to have radiotherapy after the surgery and previously it has been unclear if they would also benefit from hormone therapy.
(Image: Royal Marsden Hospital Trust)